MedStar Authors catalog › Details for: A National Perspective on ECMO Utilization in Patients with Burn Injury.
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A National Perspective on ECMO Utilization in Patients with Burn Injury.

by Nosanov, Lauren B; McLawhorn, Melissa M; Vigiola Cruz, Mariana; Chen, Jason H; Shupp, Jeffrey W.
Citation: Journal of Burn Care & Research. , 2017 Mar 31.Journal: Journal of burn care & research : official publication of the American Burn Association.Published: 2017ISSN: 1559-047X.Full author list: Nosanov LB; McLawhorn MM; Vigiola Cruz M; Chen JH; Shupp JW.UI/PMID: 28368919.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Washington Hospital CenterDepartment(s): Surgery/Burn ServicesActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: (Click here) Abbreviated citation: J Burn Care Res. , 2017 Mar 31.Local Holdings: Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present.Abstract: Extracorporeal membranous oxygenation (ECMO) has become an increasingly utilized strategy to support patients in cardiac and cardiopulmonary failure. The Extracorporeal Life Support Organization reports adult survival rates between 40 and 50%. Utilization and outcomes for burned patients undergoing ECMO are poorly understood. The National Burn Repository (version 8.0) was queried for patients with ICD9 procedure codes for ECMO. Demographics, comorbidities, mechanism, injury details, and clinical outcomes were recorded. ECMO patients were matched one-to-one to those not requiring ECMO based on age, gender, TBSA, and inhalation injury. Group comparisons were made utilizing chi and Mann-Whitney U tests. Thirty ECMO-treated burn patients were identified. Patients were predominantly male (80.0%) and Caucasian (63.3%) with mean age 38.9 +/- 20.3 years. The majority were flame injuries (80.0%) of moderate size (17.0 +/- 18.7% TBSA), affecting predominantly upper limbs and trunk. Inhalation injury was reported in 26.7%. Respiratory failure was reported in nine, acute respiratory distress syndrome in three, and pneumonia in nine. Fourteen patients survived to discharge. The ECMO cohort had significantly higher rates of cardiovascular comorbidities, concomitant major thoracic trauma, pneumonia, acute renal failure, and sepsis than non-ECMO patients (P < .05). Ventilator usage, ICU length of stay, and mortality were also significantly higher in those treated by ECMO (P < .05). Although burn patients placed on ECMO have significantly higher rates of morbidity and mortality than those not requiring ECMO, the mortality rate is equivalent to patients reported by Extracorporeal Life Support Organization. ECMO is a viable option for supporting critically injured burn patients.

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